With the increasing life expectancy and improved quality of life, the conventional prosthodontic removable treatment modalities are being replaced with implant retained fixed prostheses. A full-arch ...conventional rehabilitation of edentulous ridges requires six to ten dental implants. However, some patients demand fixed implant-supported prostheses inspite of medical conditions and economic concerns. Also in completely edentulous cases, the insufficient bone morphology directs the treatment plan towards alternatives such as cantilever prostheses, short implants or ridge augmentation procedures. These clinical conditions have brought in a quantum shift in treatment planning towards the 'all on 4 protocol' providing immediately loaded fixed prosthesis supported by 4 implants thereby providing optimum and immediate restoration of function and esthetics.
Spatially and temporally consistent vegetation structure time-series have great potential to improve the capacity for national land cover monitoring, to reduce latency and cost of international ...reporting, and to harmonize regional land cover characterizations. Here we present a semi-automatic, operational algorithm for mapping and monitoring of woody vegetation canopy cover and height at a regional scale using freely available Landsat time-series data. The presented algorithm employs automatic data processing and mapping using a set of lidar-based vegetation structure prediction models. Changes in vegetation cover are detected separately and integrated into the structure time-series. Sample-based validation and inter-comparison with existing datasets demonstrates the spatial and temporal consistency of our regional data time-series. The dataset reliably reflects changes in tree cover (tree cover loss user's accuracy of 0.84 and producer's accuracy of 0.75) and can serve as a tool to map annual forest extent (user's accuracy of 0.98 and producer's accuracy of 0.81 for 10% canopy cover threshold to define the forest class). The tree height estimates are consistent with a GLAS-based global map (mean average error of 3.7 m, the correlation coefficient of 0.92 and the R2 of 0.85). The algorithm was prototyped within the Lower Mekong region where it revealed an intensive woody vegetation dynamic. Of the year 2000 forest area (defined using canopy cover threshold of 10% and tree height threshold of 5 m), 9.4% was deforested by the year 2017, and 16.6% was affected by stand-replacement disturbance followed by reforestation. The average annual area of stand-level forest disturbance within the region was 2.34 Mha, and increased by 34% from 2001 (1.85 Mha) to 2017 (2.48 Mha). Total forest area decreased by 6.2% within the region, and 11.1% of year 2000 primary forest area was lost by 2017. At the national level, Cambodia demonstrated the highest rate of deforestation, with a net forest area loss of 22.5%. We estimated that 21.3% of 2017 forest cover had an age of 17 years or less, illustrating the intensive forest land uses within the region. The time-series product is suitable for mapping annual land cover and inter-annual land cover change using customized class definitions. The regionally-consistent data are publicly available for download (https://glad.umd.edu/), and online analysis (https://rlcms-servir.adpc.net/en/forest-monitor/), and serve as an input to the SERVIR-Mekong Regional Land Cover Monitoring System.
•Woody vegetation structure mapped through integration of lidar, Landsat, and MODIS.•A semi-automatic, operational algorithm for forest structure monitoring prototyped•The value of land surface phenology data and annual change detection is demonstrated.•Analysis-ready vegetation structure 2000–2017 time-series produced for Mekong region•The regional time-series data is suitable for annual forest monitoring and reporting.
Plasma cell gingivitis (PCG) is a diagnostic dilemma for clinicians. It is also referred to as atypical gingivostomatitis, idiopathic gingivostomatitis, allergic gingivostomatitis, and plasma cell ...gingivostomatitis which are characterized by bright fiery red gingiva with spontaneous bleeding on slight provocation. It is often confused with inflammatory gingival enlargement, erythematosus lichen planus, and other lesions. One such rare and benign entity is discussed in this article and managed after thorough clinical, radiological, histopathology, immunohistochemistry analysis.
Postweaning diarrhea in pigs is frequently caused by enterotoxigenic Escherichia coli K88 (ETEC). The aim of this study was to test the efficacy of E. coli probiotics (PRO) in young pigs challenged ...with E. coli K88. We also tested the synbiotic interaction with raw potato starch (RPS), which can be used as a prebiotic. Forty 17-day-old weaned piglets were randomly assigned to four treatments: treatment 1, positive-control diet (C), no probiotics or RPS but containing in-feed antibiotics; treatment 2, probiotic (PRO), no feed antibiotics plus a 50:50 mixture of probiotic E. coli strains UM-2 and UM-7; treatment 3, 14% RPS, no antibiotics (RPS); treatment 4, 14% RPS plus a 50:50 mixture of probiotic E. coli strains UM-2 and UM-7, no antibiotics (PRO-RPS). The pigs were challenged with pathogenic E. coli K88 strains on day 7 of the experiment (24-day-old pigs) and euthanized on day 10 of the experiment (35-day-old pigs). Probiotic and pathogenic E. coli strains were enumerated by selective enrichment on antibiotics, and microbial community analysis was conducted using terminal restriction length polymorphism analysis (T-RFLP) of 16S rRNA genes. The combination of raw potato starch and the probiotic had a beneficial effect on piglet growth performance and resulted in a reduction of diarrhea and increased microbial diversity in the gut. We conclude that the use of E. coli probiotic strains against E. coli K88 in the presence of raw potato starch is effective in reducing the negative effects of ETEC in a piglet challenge model.
Aim: The aim of this review was to investigate utility or futility of facebow for fabrication of complete denture prosthesis to maximise clinical efficiency and acceptability of complete dentures.
...Settings and Design: Systematic review following PRISMA guidelines.
Materials and Methods: A study question was designed based on PICOT model which was used to evaluate whether facebow transfer is required or not for fabrication of complete denture prosthesis. An extensive search was carried out manually and using electronic databases such as PubMed-Medline, Cochrane, Google Scholar, and Clinicaltrials.gov. Parameters under review included patient satisfaction, masticatory efficiency, occlusal adjustments, clinician time, stability and retention. Boolean operators, MeSH terms and limiters were applied to develop the search and reach to conclusive studies pertaining to study design. Literature dated between 1950 and 2019 were selected. The data extraction and assessment of the studies was done by two independent investigators.
Statistical Analysis Used: No meta-analysis was conducted due to heterogeneity of data obtained.
Results: 13690 studies were shortlisted, 13672 were excluded based on title and abstract. By the end of search phase, 07 RCTs were considered relevant. 04 studies concluded comparable/ no differences in outcome with and without use of facebow for fabrication of complete denture prostheses, whereas 03 studies concluded better results without the use of facebow.
Conclusion: The use of facebow results in fabrication of complete denture prostheses with similar results in terms of clinical efficiency and patient acceptability as compared to simplified techniques using anatomical landmarks. Variations in assessment criteria, non uniform distribution of sample size amongst different clinical trials and subjective questionnaire based criteria are the weaker links in the review. Extensive research and long term standardised studies with objective criteria for assessment are required for comprehensive and conclusive results to establish the need for change in clinical practice.
Lysozyme is a low-molecular-weight protein with antimicrobial properties. An experiment was conducted to investigate the response of piglets receiving a water-soluble lysozyme supplement Entegard ...(EG), Neova Technologies Inc., Abbotsford, British Columbia, Canada; 4,000 lysozyme units/mg after oral challenge with enterotoxigenic Escherichia coli (ETEC). A total of 36 individually housed weanling pigs were randomly allotted to 1 of the 4 treatments, with 9 replicates per treatment. Treatments were a control (CONT, no additive), antibiotic (AB; 2.5 g/kg of feed of antibiotic with chlortetracycline, sulfamethazine, and penicillin), and EG delivered in the drinking water at concentrations of 0.1% (EG1) and 0.2% (EG2). All pigs received a basal diet similar in composition and nutrients, except for pigs receiving the AB diet, which had an added antibiotic. Pigs were acclimated to treatments for a 7-d period to monitor growth performance. On d 8, blood samples were collected from each pig to obtain serum, and each pig was gavaged with 6 mL (2 x 109 cfu/mL) of ETEC solution. Pigs were monitored for another 7 d to assess incidences of diarrhea and growth performance, and then all pigs were killed to obtain intestinal tissue and digesta samples. Treatments did not influence growth performance throughout the study. Greater ETEC counts were observed in the ileal mucosal scrapings (P = 0.001) and colonic digesta (P = 0.025) of pigs in the CONT group compared with pigs in the AB and EG1 groups. Pigs receiving AB and EG1 had greater (P < 0.05) small intestinal weights and ileal villus heights than pigs receiving CONT; however, the ileal villus height-to-crypt depth ratio was greater in pigs fed the AB diet (1.69) compared with those fed the CONT diet (1.34), whereas pigs receiving EG1 were intermediate. Pigs in the EG1 group showed greater (P < 0.001) serum tumor necrosis factor α and IL-6 concentrations before ETEC challenge; however, at 7 d postchallenge, pigs receiving EG2 showed the least (P < 0.05) circulating tumor necrosis factor α and IL-6 concentrations. Overall, better intestinal growth and development, as well as decreased ETEC counts on the intestinal mucosa and serum proinflammatory cytokines, suggest that EG can maintain gut health and function in piglets commensurate with antibiotics. However, it is noteworthy that at the largest dose tested, EG seemed to have a dramatic effect on proinflammatory cytokines but had a minimal or no effect on the other response criteria.
Reducing the burden of death due to infection is an urgent global public health priority. Previous studies have estimated the number of deaths associated with drug-resistant infections and sepsis and ...found that infections remain a leading cause of death globally. Understanding the global burden of common bacterial pathogens (both susceptible and resistant to antimicrobials) is essential to identify the greatest threats to public health. To our knowledge, this is the first study to present global comprehensive estimates of deaths associated with 33 bacterial pathogens across 11 major infectious syndromes.
We estimated deaths associated with 33 bacterial genera or species across 11 infectious syndromes in 2019 using methods from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, in addition to a subset of the input data described in the Global Burden of Antimicrobial Resistance 2019 study. This study included 343 million individual records or isolates covering 11 361 study-location-years. We used three modelling steps to estimate the number of deaths associated with each pathogen: deaths in which infection had a role, the fraction of deaths due to infection that are attributable to a given infectious syndrome, and the fraction of deaths due to an infectious syndrome that are attributable to a given pathogen. Estimates were produced for all ages and for males and females across 204 countries and territories in 2019. 95% uncertainty intervals (UIs) were calculated for final estimates of deaths and infections associated with the 33 bacterial pathogens following standard GBD methods by taking the 2·5th and 97·5th percentiles across 1000 posterior draws for each quantity of interest.
From an estimated 13·7 million (95% UI 10·9–17·1) infection-related deaths in 2019, there were 7·7 million deaths (5·7–10·2) associated with the 33 bacterial pathogens (both resistant and susceptible to antimicrobials) across the 11 infectious syndromes estimated in this study. We estimated deaths associated with the 33 bacterial pathogens to comprise 13·6% (10·2–18·1) of all global deaths and 56·2% (52·1–60·1) of all sepsis-related deaths in 2019. Five leading pathogens—Staphylococcus aureus, Escherichia coli, Streptococcus pneumoniae, Klebsiella pneumoniae, and Pseudomonas aeruginosa—were responsible for 54·9% (52·9–56·9) of deaths among the investigated bacteria. The deadliest infectious syndromes and pathogens varied by location and age. The age-standardised mortality rate associated with these bacterial pathogens was highest in the sub-Saharan Africa super-region, with 230 deaths (185–285) per 100 000 population, and lowest in the high-income super-region, with 52·2 deaths (37·4–71·5) per 100 000 population. S aureus was the leading bacterial cause of death in 135 countries and was also associated with the most deaths in individuals older than 15 years, globally. Among children younger than 5 years, S pneumoniae was the pathogen associated with the most deaths. In 2019, more than 6 million deaths occurred as a result of three bacterial infectious syndromes, with lower respiratory infections and bloodstream infections each causing more than 2 million deaths and peritoneal and intra-abdominal infections causing more than 1 million deaths.
The 33 bacterial pathogens that we investigated in this study are a substantial source of health loss globally, with considerable variation in their distribution across infectious syndromes and locations. Compared with GBD Level 3 underlying causes of death, deaths associated with these bacteria would rank as the second leading cause of death globally in 2019; hence, they should be considered an urgent priority for intervention within the global health community. Strategies to address the burden of bacterial infections include infection prevention, optimised use of antibiotics, improved capacity for microbiological analysis, vaccine development, and improved and more pervasive use of available vaccines. These estimates can be used to help set priorities for vaccine need, demand, and development.
Bill & Melinda Gates Foundation, Wellcome Trust, and Department of Health and Social Care, using UK aid funding managed by the Fleming Fund.
AbstractFull-scale single-room masonry buildings of different typology, i.e., unreinforced (URM), reinforced (RM) and Confined Masonry (CM) were tested under cyclic loading in quasi-static manner to ...study the seismic performance. All the indigenously built building typologies were 3.01×3.01 m in plan and 3.0 m in height, having exactly similar material, geometry, and construction practices. Among six tests conducted, three were on original masonry system and remaining three models were URM-repaired (URM_REP), URM-retrofitted (URM_RET) and RM-retrofitted (RM_RET), with same initial features. The observations made and the test data collected were for different damage grades and displacement capacity. The present paper focuses on the analysis of experimental results in terms of lateral load capacity, stiffness degradation, displacement ductility capacity, behavior factors and energy dissipation capacities. The failure modes observed were: sliding of brick at mortar-unit interface; discrete shear cracks in masonry walls, crushing of masonry units and bending of reinforcement in tie columns. Out of the tested specimens, CM building exhibited large initial stiffness, along with higher strength, ductility, energy dissipation capacity, behavior factor and low level of structural damage. Consequent on significant cracks, CM building showed uniform stiffness reduction, while URM structure exhibited rapid stiffness degradation with minimal increase in lateral deformation.
Background
Relapse is a continuing process and should be evaluated on a long rather than short term.
Materials and Methods
Treatment records of 46 patients who underwent mandibular orthognathic ...surgery were divided into two groups, i.e. Group 1: Mandibular Advancement (MA) surgery (
n
= 26) and Group 2: Mandibular Setback (MS) surgery (
n
= 20). Lateral cephalograms were traced at T0 (01 week before surgery), T1 (01 week after surgery), T2 (01 year after surgery) and T3 (minimum 05 years after surgery) to study short- and long-term skeletal and dental relapse in horizontal, vertical and angular parameters selected for the study. Relapse was correlated with gender, age, amount of surgical movement and intra-operative change in mandibular plane angle to study effect of these factors on relapse.
Results
All horizontal, vertical and angular parameters studied showed significant relapse at short term (from T1 to T2) which continued significantly till long-term evaluation (T2 to T3) in both groups (
P
value < 0.001). Horizontal relapse in all parameters, vertical relapse in all parameters (except Pog and overbite at T1–T2) and angular relapse in all parameters (except Ramus inclination at T1–T2) was significantly higher in Group 2 compared to Group 1 (
P
value < 0.001 for all). Relapse showed significant and positive correlation with amount of surgical movement and intra-operative change in mandibular plane angle in both groups (
P
value < 0.05 for all).
Conclusion
Both MA and MS surgeries show significant relapse on both short- and long-term evaluation which it is higher in MS as compared to MA surgeries.
Enterotoxigenic Escherichia coli is a major problem in the swine industry and results in scouring, increased mortality, and poor performance in the period immediately postweaning. The traditional way ...to control this problem is to include subtherapeutic antibiotics in the feed, but this is no longer acceptable to consumers; thus, alternatives to antibiotics are needed. One of the supplements that has been effective in reducing scouring in the absence of antibiotics is animal blood products produced from the rendering process. This is also becoming a problem because of concerns regarding the transfer of transmissible spongiform encephalopathies to humans from animals. In this research, we investigated the effects of spray-dried porcine plasma (SDPP), a Bacillus subtilis direct-fed microbial (DFM), a blend of organic acids, and sweeteners on E. coli-induced scouring. A total of 108 pigs of approximately 17 d of age were assigned to 6 treatments, with 3 pigs per pen, in 2 blocks, with each block having 3 replicates. The 2 blocks were initiated approximately 2 mo apart, because a sufficient number of pigs were not available that met our inclusion criteria in the first block. Diet 1 was a negative control containing no antibiotics (NC). Diet 2 was the positive control and included the same ingredient composition as NC except that antibiotics (110 mg/kg of chlortetracycline, 110 mg/kg of sulfamethazine, and 55 mg/kg of penicillin) were added (PC). Diet 3 was equal to the NC, but with a B. subtilis probiotic (DFM). Diet 4 was the NC to which SDPP was added. Diet 5 was the NC plus a combination of SDPP and DFM (SDPP + DFM). Diet 6 was the NC plus a combination of supplements, including SDPP and a blend of organic acids, DFM, and a sweetener (Blend). At 24 d of age, the pigs were experimentally infected with 6.3 x 10⁹ cfu/mL of E. coli K88. All pigs were euthanized 7 d after infection and tissues were obtained for analysis. There were no significant differences among treatments for ADG, ADFI, G:F, plasma urea nitrogen, α-acid glycoprotein, tumor necrosis factor-α, intestinal ammonia, pH, or VFA. However, the PC and DFM treatments showed decreased (P < 0.05) scours at 24 h postinfection compared with the NC, SDPP, and SDPP + DFM diets. Mortality in the NC treatment, which did not contain antibiotics, was greater (P < 0.05) than in the other treatments. Terminal restriction fragment length polymorphism analysis of the 16S rDNA genes of digesta showed a greater incidence (P < 0.05) of Bacteroidetes in the PC and DFM diets than in the NC diet. When SDPP and DFM were included in the diet, the incidence of Bacteroidetes was also greater than in the NC diet (P < 0.05).
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